Health Literacy: The Language of a Blockbuster

Why do some brands flop and others finish first? It could come down to health literacy. But doing it right involves more than just choosing plain language over medical jargon, say Kevin Purcell and Erika Heiges, who share ways to make literacy work for brands

Need an incentive to place more emphasis on health literacy in your overall marketing plan? Here's one: It is estimated that 38% of an average brand's sales are lost to treatment non-adherence. And a key factor in nonadherence is health literacy (or the lack thereof).

In fact, low health literacy has been associated with the following:

• Higher rates of drug errors;
• Less knowledge of prevention and management of disease;
• Increased hospitalization rates;
• More frequent use of emergency rooms;
• Higher levels of illness (people with low health literacy tend to enter the healthcare system when they have more advanced stages of disease); and
• Higher healthcare costs (experts have estimated that low health literacy results in excess healthcare costs of up to about $70 billion per year).

A number of other factors impact adherence and are connected to health literacy, as shown in the table below.

Factors that can increase adherence

Health literacy connection

Trust in drug efficacy (belief that the drug will work)

Using complex language to educate patients about efficacy may leave them uncertain about the drug's positive effects

Self-efficacy (confidence in one's own abilities to take the drug correctly and manage side effects)

If language about dosing and side-effect management is complicated or vague, patients may feel overwhelmed and may hesitate to ask questions. As a result, they may be uncertain about their ability to take the drug correctly

Satisfaction with treatment information

If product information (including risk information) is complex and is written in technical terms, a patient is not likely to be satisfied

Factors that can decrease adherence

Health literacy connection

Psychological stress and anxiety

Stress and anxiety can impede reading, thinking and comprehension

Side effects (or fear of them)

Complex side effect education can make patients feel afraid of the product (e.g., listing a side effect that cannot be pronounced or understood creates a negative perception and raises concerns about a drug)

Complexity of the treatment regimen (number of drugs, number of doses per day)

If patient education about dosing is difficult to understand, the patient may perceive the treatment regimen to be too complicated

High cost of drugs

Patients who cannot locate and correctly complete forms for reimbursement programs and patient assistance can miss opportunities for financial support

Applying a health literacy lens in the development of patient-centric programs can help address potential adherence barriers and yield a number of business benefits, including:

• Improved patient awareness of your brand by providing clear and actionable information;
• Increased enrollment in your patient support programs by ensuring that the programs are easily accessible and offer the appropriate type and level of support;
• Higher utilization rates of patient access programs by making the process easy to navigate and offering clear calls to action; and
• Higher customer satisfaction by providing patients, care partners and healthcare providers (HCPs) with the appropriate tools.

How can you make health literacy work for your brand?

Traditionally, efforts to address health literacy have focused on the basic skills patients need to advocate for themselves—understanding health information and knowing how to apply it. But making health literacy work for your brand involves more than just helping people read health-related information. It should also help them:

• Find health information. Show patients how to locate reliable information on the Internet, and tell them ways to contact health and advocacy organizations to request information and support
• Self-manage a health condition. Give people pointers on such self-help tools as knowing how to interpret charts and labels, being able to decide when to take a drug and which dose to take, and forming strategies to keep track of drugs taken and doctors' appointments.
• Navigate the healthcare system. Offer advice on such topics as how to follow signage and directions within a healthcare setting and fill out health insurance, reimbursement, or patient assistance forms.

Vanda goes on mic and camera to boost understanding

To realize the value associated with providing patient-friendly health information, brand marketers must look at ways to help patients access the information they need. Consideration should be given to all the forms of media—print, verbal, video, or digital—available to patients and then to providing educational content in formats that take into account patients' various learning styles. And patients should take part in the development process to ensure that the approach and content of the materials reflect their perspectives and educational needs. This includes vetting materials to ensure that they meet your health literacy goals.

Don't forget the HCP

Providing HCPs with patient-facing tools that meet health literacy principles is important, too. Well-developed tools can enhance patient engagement and improve the patient-physician dialogue. Using such tools can help achieve the following:

Making a connection with people so they can absorb complex drug or disease information is the key to health literacy. Barriers, such as language and culture, must be overcome in order for programming to resonate. Forging that bond becomes even more difficult when your target audience's members are blind and largely unaware that treatment exists.

Vanda Pharmaceuticals is facing that challenge now. In April the company launched orphan drug Hetlioz (tasimelteon), which the FDA approved in January, marking the first treatment for non-24 hour sleep-wake disorder.

The little understood, orphan disorder affects up to 70% of people who are totally blind, causing a range of daytime difficulties including an overwhelming urge to sleep during the day. Symptoms can lead to a decrease in well-being and productivity.

Vanda has embarked on a disease awareness campaign to get the word out to the estimated 80,000 non-24 patients in the US, mostly by delivering real patient stories through a variety of media. While the campaign is in the early phase, the firm says the response has been encouraging.

A health and wellness podcast series featuring Erik Weihenmayer, the only blind person to climb Mount Everest, made its debut in February, including insights from physicians, life coaches and other individuals living with this disorder.

It complements non-branded radio ads that have been making the rounds nationally since October. The ad is sparse on background noise or sound effects; listeners hear only the voice of a real patient, identified by Vanda as “Lynn.”

Vanda has not only taken to the microphone. Its Non-24 Share More Campaign is also on camera: In March, a slate of non-24 awareness TV spots (pictured above)—also featuring actual ­patients—aired against such network programs as Big Bang Theory, House and Law & Order: SVU.

Vanda says the spots are running as a pilot. Many blind people actually listen to TV, through services that describe video. A digital awareness pilot, leveraging non-24.com, is also underway.

“After extensive research with the blind community and its advocates, we've designed a commercialization approach to appropriately address the need of our patients in the context of this orphan disorder,” said Vanda CEO Mihael Polymeropoulos during a call with analysts earlier this year.

“All metrics now of this campaign suggest a steady growth” in identification of new patients.

The TV ads are also designed to reach physicians. The challenge among HCPs is a little different, Polymeropoulos said, in that most of the 2,000 or so sleep doctors around the country are aware of circadian rhythm disorders. They can recognize blind patients with sleep-wake disorder, and differentially diagnose non-24.

“However,” he said, “as expected for a rare disorder and in the absence of any therapeutic, historically, they have treated very few patients.”

That could change if Vanda's ads succeed in upping understanding across the blind community. —Marc Iskowitz

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